Stitch-induced caecal fecolith: An unusual long-term complication following laparoscopic appendicectomy

A fecolith is a mass of accumulated hardened faecal matter usually seen in patients with Chagas disease, Hirschsprung's disease and inflammatory bowel disease. We report a 21-year-old female with chronic right lower abdominal pain post-appendicectomy. An abdominal computed tomography revealed a fecolith near the caecum and a right simple ovarian cyst. On diagnostic laparoscopy, a Prolene stitch in the previous appendicectomy site acting as a nidus and forming a fecolith was noted. It was excised by a small enterotomy and primary closure of the same. She had an uneventful post-operative course. This case highlights the danger of using a non-absorbable suture for appendicectomy and the rare phenomenon of fecolith formation post-appendicectomy after 4 years presenting with features of chronic recurrent abdominal pain.